Remote monitoring. Smart sensors. Better communication and overall patient care. The internet of things has some incredible applications for the health industry — assuming we can overcome the security challenges it brings with it. But where do we start?
The potential of the Internet of Things to revolutionize the world has already been well-documented – as has its potential security shortcomings. I don’t believe it’s hyperbole to call IoT one of the most disruptive digital technologies ever developed, if not the most. But that disruption can easily be a double-edged sword.
Consider the healthcare industry, for example. Hospitals, care providers, and covered entities regularly work with some of the most sensitive data in the world, subject to some of the most stringent protections. They have an inarguable duty of care to keep protected health information (PHI) out of the wrong hands.
Incautious application of IoT technology runs directly counter to that duty of care.
Unless you want your organization to be included in that statistic, you’re going to need to take a step back and re-examine your security practices. The Internet of Things is by its very nature unlike any technology you’ve used in the past. What that means is that it requires a completely different approach.
You must have some way of monitoring, managing, and locking down any endpoints that might have even a passing connection to patient data. You need to implement new processes and procedures regarding how devices are used and interconnected within your organization. Finally, you need to be aware of PHI no matter where it is and who’s using it — and if someone is accessing it who shouldn’t be, you need the capacity to lock down their access and protect that data.
For an industry where even standard IT can prove challenging, that’s a pretty intensive list. It’s a small wonder, then, that many healthcare organizations choose to work with managed services providers rather than deal with things internally. And if, after a security assessment, you find that your own IT staff lack the expertise, that might be the best bet for you as well (at least until your staff can receive proper training).
Of course, selecting an IoT services provider comes with its own laundry list of challenges. You’ll need to school yourself in the tactics and language the bad eggs use to try to lure in new clients, and you’ll need to ensure that any providers you work with are fully HIPAA-compliant. There are a few signs you should look out for in that regard:
Ivenix, Inc., a medical technology company with a vision to eliminate infusion-related patient harm, was founded in 2012 to develop innovative solutions that transform infusion delivery. Designed from the ground up to streamline medication delivery and bring legacy technology into the digital age, the Ivenix Infusion System includes a large-volume infusion pump supported by a robust infusion management system designed to set new standards in usability, medication precision and interoperability.
Founders’ story
Today’s IV smart pumps rely on technology developed more than a decade ago and continue to put patients at risk. At Ivenix, we believe it’s more important than ever to empower clinicians with the most effective infusion equipment, training and processes to ensure they do no harm. No hospital wants to wonder: “Are we doing enough? Are we making every effort to prevent infusion mistakes?” We are all patients. And Ivenix is dedicated to the belief that infusion technology should put patients first with enhanced outcomes and a better patient experience, while dramatically improving clinical workflow and efficiency. It’s what inspires us, motivates us, and brings us together for the shared purpose of delivering groundbreaking infusion innovation to healthcare.
Marketing/promotion strategy
Ivenix is generating awareness through a number of channels, and has partnered with industry associations, such as HIMSS, IHE and AAMI, which has an Infusion Safety Therapy Coalition, to address current market issues in infusion safety, interoperability and innovation. Ivenix is also testing its infusion pump system with a number of integration partners, including leading EMR, alarms management and clinical communication vendors to provide interoperability solutions.
Market opportunity
Ivenix is addressing the $9 billion global infusion pump market, with first targeted efforts on the U.S. large volume pump market, a $2..6 billion market segment that represents the majority of infusion pumps used in the U.S. hospital and ancillary clinic market.
Who are your competitors?
Braun, BD, ICU Medical, Baxter
How your company differentiates itself from the competition and what differentiates Ivenix?
Ivenix has developed an infusion platform to address an industry fraught with medication errors. Infusion-related errors account for more than 50 percent of the 1.5 million adverse drug events reported annually to the U.S. Food and Drug Administration (FDA). Between 2015 and 2017, more than 23,000 pump malfunctions, including subsequent injuries, were reported to the FDA. With today’s pumps, infusion errors are attributed to error-prone programming tasks, usability issues and clinical use, inaccurate flow, hardware failures and outdated designs with limited information. Currently, less than 1 percent of IV pumps are fully integrated with electronic medical records. Ivenix is rethinking infusion delivery to set new standards in safety, simplicity, and interoperability, Ivenix designed its infusion system on three fundamental dimensions:
Patient-centered design: Intuitive design enables faster bedside setup and lowers risk of programming errors, benefiting patients because clinicians spend less time troubleshooting pumps or resolving nuisance alarms.
Integrated data-driven insights: Advanced IT platform integrates with the EMR and other hospital information systems, securely manages data and connects clinicians with patient-specific knowledge to be better informed – and therefore make better decisions – at the bedside.
Adaptive fluid delivery: Advanced pump technology reduces clinical variability of medication delivery to help improve patient outcomes.
Healthcare delivery is being transformed as we speak, from technological breakthroughs and regulatory change to changing patient demographics and consumer expectations. As the healthcare landscape evolves, forward-looking healthcare providers are seeing their real estate in a new light. It’s time for healthcare providers to consider new approaches to real estate and facilities as a way to improve efficiency and patient outcomes.
Following are four ways hospitals and health systems can stay ahead of the curve.
Leverage the M&A boom to improve facilities performance and value. While 2017 seemed to be the year of hospital M&A, JLL analysis points to an even higher volume of M&A in 2018. Cost containment is often a key motivator for initiating M&As. In the aftermath of consolidation, many health systems are now sitting on large portfolios of underutilized real estate that represent a major source of value and capital investment. A data-driven analysis can help identify opportunities to drive more value from each facility and put each to its highest and best use.
Unlock operational efficiencies with a centralized approach. As health systems expand their real estate portfolios with diverse outpatient facilities, centralized facility management and maintenance may be the most efficient way to manage their growing footprints. Partnering with a third-party facility management service provider is a common path to centralization, although it is critical to partner with a firm that understands the nuances of the healthcare environment.
Centralized control of facilities data and analytics provides a complete picture of how different facilities are performing, so the facilities team can make accurate capital plans based on data rather than informed guestimates. Also, today’s facility management technology supports preventive maintenance and can even generate automated alerts if a building system is malfunctioning or approaching a complete breakdown. In addition to improving efficiency, a facilities management partnership can help reduce compliance risks and improve patient and staff satisfaction.
Embrace new definitions of what it means to be a health system—and how that plays out on the map. Though hospitals remain a critical focus, traditional networks may soon be rendered obsolete as industry leaders find that new opportunity lies outside the hospital campus. From medical office buildings to healthcare-anchored retail centers, tailored care settings can improve the patient experience and increase patient loyalty—and boost the hospital balance sheet.
However, managing a complex network of medical facilities requires a thoughtful strategy informed by location analysis. Thinking differently can reap big rewards, but it’s important for executives to carefully weigh the risks and benefits of paying a little more to be closer to where patients already spend time.
With every sector of the economy feeling the effects of ever-increasing healthcare costs and no relief in sight, it’s no wonder household names outside of traditional healthcare are stepping in and attempting to improve what could only be characterized as a problematic system.
Industry outsiders take an interest in “solving” healthcare
This year began with three modern-day titans of industry declaring they are ready to disrupt healthcare. Jeff Bezos of Amazon, Warren E. Buffett of Berkshire Hathaway, and Jamie Dimon of JP Morgan Chase announced they were forming an independent healthcare company for their employees. By June they named a CEO for this venture: Dr. Atul Gawande. A Harvard surgeon, author, and executive director for Ariadne Labs, Dr. Gawande has built his career on examining how medicine is practiced in the US.
Industry outsiders see data as a key leverage point
What is noticeably apparent with this surge in “healthcare outsiders” is that none of these big players are attempting to remake all of healthcare. To remake a system as vast and complex as the US healthcare system is more than any one company or consortium can reasonably hope to do.
However, they all do seem to be focused on data as the key point of leverage for disrupting and remaking a segment of healthcare. Gathering and processing data into diagnostic, predictive, or operational information is seen as the leverage point for ultimately making healthcare more efficient and effective.
Some of these industry outsiders are focusing their efforts directly on finding and exploiting opportunities for cost savings. Here are some examples.
Optimizing the pharmacy purchasing experience
Making the patient purchasing experience for pharmaceuticals, medical devices, and medical supplies seamless and reliable has drawn the attention of Amazon.
For the patient ordering and refilling prescriptions, the process could be automated and culminate in same-day delivery to the patient’s door. To some extent, patients will be able to comparison shop for non-prescription items and bundle purchases. For the seller inventories and distribution can be centralized and possibly some operational savings can be realized.
Finding a more efficient way of selling and delivering medical supplies will increase convenience for patients. But patients rarely pay the full cost of their prescriptions, so the cost drivers present in optimizing retail sales aren’t present at the pharmacy.
By Poornima Venkatesan, senior consultant, Virtusa.
Poornima Venkatesan
In today’s value-based care environment, patient engagement is a vital key to success in clinical outcomes. This is especially true for chronic diseases such as arthritis, where continuous care is necessary because of the disease’s physical, emotional and economic impact on patients. Although the advent of specialty drugs in the past decade has made disease control possible, clinicians still face challenges in patient care because patients’ preferences about therapy aren’t often considered.
Understanding patient goals and expectations
While a clinician’s goal is to achieve remission, a patient’s goal could be clinical or nonclinical and varies depending on their individual characteristics and demographics.
Patients from low-income countries such as Morocco expect access to primary care (never mind rheumatologists), support services and education about the disease. The high expenses related to rheumatoid arthritis (RA) in such countries result in poor treatment compliance, school absenteeism in children and deterioration in quality of life. Comparatively, even with excellent health insurance systems in the United States, one in six adults with RA reduce their medication use because of high out-of-pocket costs. Most patients expect cost-effective care. In wealthier countries like the United Kingdom, patients expect increased social connectedness and family support.
Elderly patients expect reduced pain, fatigue and side effects, whereas young adults expect independence and normalcy from their treatments. Women, who are most affected by RA, might expect a lesser impact on family life and childrearing.
If such multidimensional expectations are not met, patients tend to discontinue their treatment. As new biologics and non-biological complex drugs (NBCDs) are developed, patient adherence is essential in determining both therapeutic and potential adverse effects. Studies reveal that frustration towards the method of drug administration (like self-injection) also impacts adherence. In the U.S alone, the total cost of non-adherence is estimated between $100 billion and $289 billion annually.
Therefore, it is important for the patient and the physician to trust each other and have open discussions about treatment strategies and expectations to ensure better alignment and cooperation.
Measuring patient engagement
The first step towards patient engagement is awareness of their current engagement levels. The patient activation measure (PAM) tool is helpful here. PAM measures the attitude and knowledge of patients about the disease and treatments. Studies have proven that highly activated patients have better outcomes via increased medication adherence, resulting in lower healthcare costs through fewer ED visits, hospital admissions and re-admissions. By continuously monitoring activation levels, providers can measure sustained changes in patient behavior and personalize their care programs.
We can also measure engagement levels by taking advantage of data. Data derived from direct [electronic health records (EHR), claims] and indirect sources (wearables) provide a holistic view of an individual patient. Simple analytics applied to population data can predict patient behavior. For example, analytics can help providers know which patients are likely to miss their appointments, which patients will fill their prescriptions on time, and so on. Detailed patient-based data could also lead to better and more accurate diagnoses and treatments.
The 21st century has seen a massive change in the way people live their lives. It is now the digital era, and almost everything is online or made available in electronic form. There are now jobs online. Elections are now run in many countries so that people can submit votes electronically. Hotel bookings and other travel accommodations can be done online. Even bank transactions are done over the web.
One of the most consequential manual-to-digital revolutions is the US government’s drive to create electronic health records (EHRs) from the mountains of filed information for patients. The main aim is to make medical information available to all concerned parties whenever needed. The long term goal is making healthcare significantly more effective.
This policy direction delivered a jolt to the medical IT industry, inspiring hospitals all over the US to start looking for digitalization partners. It has also pushed clinics and hospitals to standardize their functions, especially those that relate to drug formulas.
Because of the scale and promise of these standardization efforts, health and pharmaceutical leaders and administrators are wondering how to best respond and take advantage of the EHR frenzy. Here are some of the ways that pharma companies can plan for the future…
Intensify efforts to get empirical support for product effectiveness.
The digitization of almost everything has bestowed on people the power of more effective insight. The mountains of data that is being digitized can be searched for trends, such as the effectiveness of one prescription over another. Informative resources that allow anyone to immediately refer to them for help in making crucial decisions regarding health are now on the horizon.
To make their products appealing to doctors and patients, pharmaceutical companies can focus on getting empirical support for their claims. They can conduct many forms of scientific analysis on the use and effectiveness of their drugs.
However, be careful not to interpret with the results just so they project only a positive image. Bear in mind that the main purpose of testing is to understand the actual mechanisms at play and eventually get ideas on how to improve. Tests should never be aimed at getting marketing support points, though those are going to be very welcome bonuses if that is what the study uncovers.
CarePort Health provides post-acute care management solutions for hospitals, payers, ACOs and post-acute providers to better manage patient care across the continuum.
Elevator pitch
CarePort Health bridges the data gap between acute and post-acute care to help improve patient outcomes.
Founders’ story
Lissy Hu
Since CEO and co-founder Dr. Lissy Hu immigrated from China to the U.S. at seven years old, Hu has been immersed in the healthcare landscape. Her mother worked as a home health aide helping vulnerable populations so, at an early age, Hu learned the compassion and hard work that went into helping patients. It was through her family’s influence that Hu decided to dedicate her career to helping underserved and vulnerable patient populations. After completing her pre-med at Columbia University, Hu did a healthcare fellowship where she worked with 3,000 high-cost Medicare patients in the Bronx. It was here that she was exposed to the gaps between acute and post-acute care – ultimately, there was no way to know how her patients were doing once they left the hospital setting. This black hole her patients were going into once discharged left Hu perplexed, but also motivated to do something about it. After her fellowship, Hu pursued a joint MD/MBA from Harvard. During that time, she developed the idea that is now CarePort, launching the company after winning a business plan competition in 2012. In 2016, CarePort Health was acquired by Allscripts, one of the largest EHR solutions providers. The company’s Boston-based team recently moved into a new, larger office space to accommodate its expanding team.
Marketing/promotion strategy
CarePort Health partners with hospitals, payers, accountable care organizations (ACOs) and post-acute providers to give access to its suite of solutions including CarePort Guide, CarePort Connect and CarePort Insight. The shift to value-based care has motivated healthcare organizations and their providers to have a heightened lens on patient health beyond the hospital, and CarePort is one solution that provides that level of visibility.
Market opportunity
CarePort’s customers are primarily hospitals, payers, ACOs and post-acute providers like skilled nursing facilities. One-in-five patients are admitted to post-acute care after being discharged from the hospital – nearly 8 million patients annually. With an aging population, this number is set to increase. Today, most patients that need post-acute care are handed a piece of paper by the nurse or physician that includes a list of names and addresses – no other context. Not only is this a confusing time for the patient, but also their families. Having to decide where they receive care next based off a list of names does not provide proper guidance into the type of care they will receive. By leveraging CarePort Health’s suite of solutions, providers and their patients can look deeper into the facilities being suggested and make a more informed clinical decision.
The CarePort platform consists of three tools to improve post-acute outcomes:
CarePort Guide: Simplifies post-acute provider selection to make it as informed and intuitive as booking a hotel.
CarePort Connect: Empowers providers across the continuum – hospitals, payers, ACOs, and post-acute providers – to coordinate care through real-time information sharing. Intuitive and web-based, CarePort Connect breaks down silos of patient information to connect previously disparate providers with shared patients through real-time, actionable data sharing.
CarePort Insight: Provides organizations with real-time analytical reports that are easily generated with multiple drill-down options and filters for provider, patient type and/or condition.
Care Management – A complete Acute Case Management, Discharge Planning and Utilization Review workflow tool with a built-in network of more than 20,000 providers.
Referral Management – An intake, referral management and discharge planning tool for post-acute care providers.
Who are your competitors?
CarePort Health has designed tools unique to the market and, therefore, does not have direct competitors. There are a few companies in the market that have similar tools. However, CarePort Health is the only company that utilizes rich data sets to provide a much more comprehensive look into post-acute care settings for each patient.
How does your company differentiate itself from the competition and what differentiates CarePort Health?
CarePort Health is the only company that has developed three unified tools to help providers and their patients make more informed decisions for post-acute care management. Patients are no longer making decisions based off a flat list of names and addresses. CarePort’s technology allows them to look at the full spectrum of the care being offered by each facility and how it can meet their healthcare needs.
By Zachary Blunt, manager of product management population health, Greenway Health
Zachary Blunt
Electronic health records (EHRs) were expected to revolutionize healthcare practices, making them more efficient, reducing costs and enabling them to provide more coordinated care.
But ask healthcare providers about the EHRs they’ve deployed, and the results are far from what was expected.
In fact, more than 60 percent of healthcare professionals rank their return on investment (ROI) for EHR systems as “terrible” or “poor,” according to a recent survey from Health Catalyst. Another study, published in the Journal of the American Medical Association, estimated the costs of billing and insurance-related activities using EHRs ranged from $20 for each primary care visit to $215 for inpatient surgery, totaling 3 percent to 25 percent of professional revenue.
So, why aren’t EHRs living up to the hype and delivering the promised investment? In many cases, it has to do with these systems not being used to their highest potential.
Here’s a look at five steps healthcare practices can take to address challenges resulting from EHR implementation and maximize their ROI.
Get Buy-In Across the Board — from IT to Finance to Front Office Staff
Adopting EHRs to manage clinical activities impacts many revenue cycle-related functions, such as patient registration, insurance eligibility, scheduling and the services/treatments a patient received during each clinical encounter. To achieve ROI, EHRs must be able to improve several operations of a practice and streamline the workflows of different departments. It’s best practice for all clinicians and staff to weigh in before installing new systems or technologies.
Provide Strong Leadership, Communication and Training
Changes in common practices during EHR implementation can result in significant resistance from users or a longer learning curve that hampers efficiency and adds to the cost of the system. To achieve results, healthcare leaders should clearly articulate the EHR implementation plan, prepare themselves for a transition period and develop a training protocol so all users understand their roles in using the system. In addition, users should have a solid background and understanding on how their roles factor into the overall success of the system and the practice at large.
Improve Staffing Efficiency While Improving Operating Margins
Labor costs can account for nearly half of a healthcare provider’s operating costs. But providers often fail to take a strategic look at how adjusting staffing can improve the bottom line. Often, providers use historical averages to determine staffing levels at their practices, resulting in an outlay of overtime pay outside the planned budget when unexpected staffing demands occur. Data from EHR solutions, as well as enterprise resource planning (ERP) sources, can be analyzed to gain a better understanding of historical staffing trends. Accenture estimates that by getting insights from EHR and ERP data, U.S. healthcare providers could save more than $77 billion over the next five years by reducing overtime and overall labor costs.
Ivenix, Inc.
The 21st century has seen a massive change in the way people live their lives. It is now the digital era, and almost everything is online or made available in electronic form. There are now jobs online. Elections are now run in many countries so that people can submit votes electronically. Hotel bookings and other travel accommodations can be done online. Even bank transactions are done over the web.
